| NPI | 1306840806 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: ME 012519) |
| Additional Taxonomies | 207U00000X Nuclear Medicine (Licence: ME 012519) |
| 208600000X Surgery (Licence: ME 012519) | |
| Enumeration Date | 2005-06-13 |
| Last Update Date | 2007-07-16 |